metrizamide and Epilepsy--Absence

Acute confusional state following metrizamide myelography has been reported to occur in up to 2% of patients. These patients have been diagnosed as having toxic encephalopathy. Recently, various cases have been reported to have a nonconvulsive status (absence status or complex partial status) who responded well to diazepam or clonazepam therapy. However, some authors have described cases of nonresponders to anticonvulsive therapy. Failure of therapy can be dose-related. For this reason, our patient was closely monitored by EEG to determine if dose adjustment was warranted, thereby achieving good results.

Topics: Clonazepam; Dose-Response Relationship, Drug; Electroencephalography; Epilepsy, Absence; Humans; Male; Metrizamide; Middle Aged; Myelography

Epileptic seizures are a known complication of metrizamide myelography. To our knowledge, this is the first report of a case of nonconvulsive status epilepticus of the absence type following metrizamide myelography. There was symptomatic and electroencephalographic improvement after intravenous administration of antiepileptic drugs, and there was no neurological residual. Nonconvulsive status epilepticus should be considered when impairment of consciousness supervenes after radiographic procedures using metrizamide.

Topics: Electroencephalography; Epilepsy, Absence; Humans; Male; Metrizamide; Middle Aged; Muscle Spasticity; Myelography; Paraplegia; Spinal Osteophytosis; Status Epilepticus